Objective

Adverse childhood experiences (ACEs) and restricted food access have been associated with risk for eating disorders (EDs). This study examined the relationship between childhood food neglect, an ACE specifically involving restricted food access, and DSM-5-defined EDs in a nationally representative sample of U.S. adults, with a particular focus on whether the relationship persists after adjusting for other ACEs and family financial difficulties.

Methods

Participants were 36,145 respondents from the National Epidemiological Survey on Alcohol and Related Conditions III (NESARC-III) who provided data regarding childhood food neglect. Prevalence rates of lifetime anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) were determined for those who reported versus denied childhood food neglect. Analyses compared the odds of each ED diagnosis after adjusting for sociodemographic characteristics (Model 1) and further adjusting for other ACEs and governmental-financial support during childhood (Model 2).

Results

Prevalence estimates for AN, BN, and BED with a history of childhood food neglect were 2.80% (SE = 0.81), 0.60% (SE = 0.21), and 3.50% (SE = 0.82), respectively and 0.80% (SE = 0.07), 0.30% (SE = 0.03), and 0.80% (SE = 0.05) for those without a history (all significantly different, p < .05). In the fully-adjusted model, odds of having an ED diagnosis were significantly higher for AN (AOR = 2.98 [95% CI = 1.56–5.71]) and BED (AOR = 2.95 [95% CI = 1.73–5.03]) in respondents with a history of childhood food neglect compared with those without.

Conclusion

Individuals who experience childhood food neglect may be at increased risk for AN and BED and the elevated risk exists after adjusting for other adverse experiences and financial difficulties during childhood.

中文翻译：

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在美国国家样本中，儿童饮食方面的忽视和与DSM-5饮食失调相关的不良经历。

目的

不良的童年经历（ACE）和食物获取受限与饮食失调（ED）的风险有关。这项研究检查了美国成年人在全国范围内的抽样调查中儿童饮食的忽视，一种特别涉及限制食物获取的ACE与DSM-5定义的ED之间的关系，特别侧重于在调整了其他ACE和家庭后这种关系是否仍然存在财政困难。

方法

参与者是来自全国酒精与相关疾病流行病学调查III（NESARC-III）的36,145名受访者，他们提供了有关儿童食品忽视的数据。对于那些报告与否认儿童饮食忽视的人，确定其终生神经性厌食症（AN），神经性贪食症（BN）和暴食症（BED）的患病率。分析人员比较了社会人口统计学特征（模型1）并进一步调整了儿童时期的其他ACE和政府财政支持（模型2）后，每种ED诊断的几率。

结果

曾有儿童饮食忽视史的AN，BN和BED患病率分别为2.80％（SE  = 0.81），0.60％（SE  = 0.21）和3.50％（SE  = 0.82）和0.80％（SE  = 0.07） ）， 无病史的患者为0.30％（SE  = 0.03）和0.80％（SE = 0.05）（均存在显着差异，p  <.05）。在完全调整模型中，受访者对AN（AOR = 2.98 [95％CI = 1.56-5.71]）和BED（AOR = 2.95 [95％CI = 1.73–5.03]）进行ED诊断的几率显着更高。与没有饮食的儿童相比，有儿童饮食历史的人。

结论

经历儿童期食品忽视的个体患AN和BED的风险可能会增加，并且在调整了儿童期的其他不良经历和经济困难后，存在较高的风险。